Latent profiles of perceived discrimination, bicultural stress, and negative context of reception and associations with mental health in a sample of Hispanic and Somali adolescents.

OBJECTIVE: Ethnic minority youth experience multiple sociocultural stressors, experiences that are distinct from general measures of perceived stress. The present study aims to identify heterogenous subgroups of youth based on three self-reported sociocultural stressors (bicultural stress, perceived discrimination, and perceived negative context of reception). METHOD: Data are from a pilot study of Hispanic and Somali immigrant-origin youth (N = 291, 46.4% Hispanic) residing in an urban midwestern setting (Mage = 15.9 years [SD = 1.5]; 48.5% female, 35.7% first generation). Using latent profile analysis, three empirically derived profiles described as low cultural stress, high perceived discrimination, and high bicultural stress were identified. Multinomial logistic regression models predicted class membership using theoretically and empirically supported correlates (age, race/ethnicity, gender, socioeconomic status, and nativity) and examined class association with anxiety and depression. RESULTS: Compared to the low cultural stress profile, Relative Risk Ratios (RRR) indicated that membership in the high perceived discrimination profile was associated with age (RRR = 1.81, 95% CI [1.14, 2.86]) and generational status (e.g., U.S. born vs. first-generation; RRR = 0.0.22, 95% CI [0.07, 0.75]) but not depression or anxiety whereas membership in the high sociocultural stress profile was associated with elevated past week anxiety (RRR = 2.57, 95% CI [1.86, 3.54]), but not depression. CONCLUSIONS: The experience of sociocultural stress is heterogenous and certain demographic characteristics, such as age and generation, and high sociocultural stressors, especially bicultural stress, may be important considerations in identifying youth that would benefit from tailored support services. Further work exploring how sociocultural stressors affect mental health among immigrant origin youth is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Negative perceived context of reception and sociocultural resources on mental health among Hispanic and Somali adolescents.

Although immigrant negative perceived context of reception (PCOR), perceptions of the opportunities and degree of acceptance in an immigrant-receiving community, has been linked with compromised adolescent well-being, receiving contexts may differ by region and for youth from different ethnic backgrounds. The current study examines how negative PCOR and factors that promote resilience differentially shape mental health among Hispanic and Somali adolescents in Minnesota. Hispanic (n = 163) and Somali (n = 186) first- and second-generation youth aged 12-19 completed a survey on negative PCOR, assets and resources (i.e., ethnic identity, social support, religious participation), and mental well-being (i.e., anxiety and depressive symptoms). Parents and caregivers also completed a survey on PCOR and social support. Adolescent negative PCOR, relative to parent/caregiver negative PCOR, was associated with higher adolescent anxiety and depressive symptoms. Religious participation and social support, reported by both parent/caregiver and adolescent, was associated with lower anxiety and depressive symptoms. Additionally, among Hispanic adolescents, social support buffered the effects of negative PCOR on depressive symptoms. Conversely, strong ethnic identity was associated with higher depressive symptoms for both groups, suggesting acculturative and assimilative pressures play an important role in adolescent mental health. Although social ties can be weakened postmigration, our results indicate that social and religious resources remain beneficial. Given that by the end of the next decade over 50% of the US youth population will identify as part of a racial or ethnic minority group, positive postimmigration adaptation is a critical public health concern.

Adverse childhood experiences and sleep difficulties among young adult college students.

Although adverse childhood experiences (traumatic events such as maltreatment and household dysfunction) are associated with increased risk for sleep difficulties among adults, the association between adverse childhood experiences and poor sleep health among young adult college populations is understudied. This study examined the adverse childhood experience-sleep health (self-reported sleep difficulty and diagnosis of insomnia or "other" sleep disorder) association among college students. Data are from the 2018/2019 American College Health Association-National College Health Assessment II (ACHA-NCHA-II) survey administered at public universities in California (n = 3606) and Texas (n = 407). Logistic regression models investigated the relative effect of adverse childhood experiences (maltreatment only, household dysfunction only, and maltreatment + household dysfunction) on three sleep health indicators. Approximately 40% of the sample reported adverse childhood experiences: 11% maltreatment only, 14% household dysfunction only, and 17% both. Compared with students with no adverse childhood experience history, students who reported only household dysfunction or only maltreatment had higher odds of experiencing sleep difficulty in the past year [adjusted odds ratios: 1.52-2.40; 95% confidence intervals: 1.26-2.97]. Additionally, students who reported maltreatment only had 2.47 times the odds of receiving an insomnia diagnosis [95% confidence interval: 1.52, 4.01]. However, students who reported both had higher odds of all three sleep health indicators: past-year sleep difficulty, insomnia diagnosis, and "other" sleep disorder diagnosis [adjusted odds ratios: 2.53-3.10; 95% confidence intervals: 1.51-4.66]. Sleep is an important facet of health among the college student population, and plays a crucial role in overall well-being, psychosocial processes, attention and academic success. Results point toward a need for sleep health programmes and interventions on college campuses focused on healthy sleep behaviours in order to mitigate further negative health effects.

Using a multi-module web-app to prevent substance use among students at a Hispanic Serving Institution: development and evaluation design.

BACKGROUND: Despite effective strategies to prevent substance use and substance use disorders among college students, challenges remain. As young adults' preference for and comfortability with web-based technology continues to increase, leveraging innovative approaches to rapidly evolving mHealth technology is critical for the success of lowering the risk for substance use and related consequences in college populations, and especially those at Hispanic Serving Institutions. Therefore, the present study describes the rationale, development, and design of iSTART, a novel web-app to prevent substance use among students. METHODS: The web-app was developed following the intervention mapping protocol, and in collaboration with numerous stakeholders, including a community-based partner specializing in substance abuse prevention and treatment. A 30-day multi-module web-app intervention was developed based on key theoretical constructs, behavior change strategies, and practical module components: attitudes (knowledge), perceived susceptibility (risk perceptions), subjective norms (normative re-education), and self-efficacy (refusal skills). This intervention will be evaluated via a time series design using a sample of 600 students randomly assigned to either the intervention, comparison, or control condition at a public institution in southern California. DISCUSSION: The iSTART web-app is an innovative and sustainable program ideal for college campuses with diverse student populations. If this prevention web-app is successful, it will significantly contribute to the evidence of effective substance use interventions in the college setting, and identify the benefits of mHealth programs to prevent future substance use. TRIAL REGISTRATION: NCT05362357 retrospectively registered on May 4, 2022 on clinicaltrials.gov .

Associations between network-level acculturation, individual-level acculturation, and substance use among Hispanic adolescents.

Acculturation is associated with substance use behaviors in Hispanic adolescents. However, there is limited research determining whether the individual's friends' acculturation patterns also influence substance use. Tenth-grade students (N = 970) participated in Project RED, a study of substance use and social networks among Hispanic youth in Southern California. Acculturation and substance use data from both the respondent and their nominated friends were regressed on lifetime cigarette use, marijuana use, and alcohol use controlling for sibling substance use, sex, depressive symptoms, and network measures. Respondent's Hispanic orientation was significantly associated with lower odds of both cigarette and marijuana use, whereas respondent's friends' US orientation was associated with higher odds of cigarette use. When controlling for network-level acculturation, individual-level U.S. orientation was not associated with substance use. Participants who nominated more friends had lower odds of cigarette use. Among this sample of Hispanic adolescents, affiliating with U.S.-oriented friends was associated with a higher risk for smoking. Substance use prevention efforts should consider encouraging Hispanic youth to maintain their cultural heritage and foster friendship groups that support abstinence and promote Hispanic and bicultural identity.

Childhood Trauma and Prescription Drug Misuse in a College Population.

INTRODUCTION: Adverse childhood experiences (ACE) predict health-compromising behaviors such as substance use. However, few studies have examined the association between ACE and prescription drug misuse among young adults-a growing public health concern. College students are especially vulnerable to prescription drug misuse due to social and academic stressors. This study investigated associations between ACE and prescription drug misuse (e.g., antidepressants, opiates, sedatives and stimulants) among a diverse college population, as well as gender and racial/ethnic variations in these associations. Methods: Data are from the 2018 American College Health Association's National College Health Assessment II (N = 3899) at a large, diverse university in California. Logistic regression models assessed the association between ACE and prescription drug misuse adjusting for gender and race/ethnicity and explored gender and racial/ethnic differences in the ACE/prescription drug misuse association. Results: ACE was associated with misuse of all prescription drugs. Due to significant effect modification by ethnicity in the relationship between ACE and stimulant misuse (p < 0.05), models were stratified by race/ethnicity. Every additional ACE was associated with an increase in adjusted odds of stimulant use among students identifying as Asian/Pacific Islander (API) and Hispanic, but not Whites. Conclusions: This study contributes to the mounting evidence regarding the importance of ACE screening and the use of campus-based prevention programs. This study also suggests programs should be tailored to address cultural variation.

Psychometric evaluation of the perceived context of reception scale among Hispanic and Somali adolescents.

OBJECTIVES: This study validates the psychometric properties and correlates of the perceived context of reception (PCOR) scale, a measure of immigrant youth's perceptions of the openness or hostility of their receiving communities, among Hispanic and Somali adolescents. METHODS: Confirmatory factor analyses (CFA) was conducted to assess the properties of PCOR among a sample of first- and second-generation Hispanic and Somali youth (N = 311) recruited in the Twin Cities metro area of Minnesota. RESULTS: CFA results provided evidence that the negative dimension of PCOR was structurally equivalent across ethnicity and generation and has acceptable internal consistency reliability. Negative perception of the receiving community's attitude toward newcomers was positively correlated with perceived discrimination, depressive symptoms, and anxiety. CONCLUSION: Results suggest that negative PCOR is cross-ethnically valid and that perceptions of the receiving community should be considered an important component of immigrant adaptation.

Adverse Childhood Experiences and Health Indicators in a Young Adult, College Student Sample: Differences by Gender.

BACKGROUND: The original Adverse Childhood Experiences (ACE) study demonstrated strong, graded relationships between child maltreatment and household dysfunction and adult health status. The present study re-examined these relationships in a sample of young adult, college students to better characterize the developmental timing of health problems related to ACE exposure and differences by biological sex. METHOD: A cross-sectional general health questionnaire that included items on ACE was administered to young adults (ages 18-29) at universities in California (n = 3880), Minnesota (n = 7708), and Texas (n = 451) between 2017 and 2018. Seven ACE were assessed: psychological, physical, or sexual abuse; violence between parents; or living with household members who were substance misusers, mentally ill, or ever imprisoned. Binary health indicators were regressed on number of ACE as 0 (referent), 1, 2, 3, and 4 or more using logistic regression controlling for age, biological sex, race/ethnicity, and site. RESULTS: Approximately 51.7% of the sample reported at least one ACE with a significantly higher rate among Texas participants (p < 0.001). We observed graded relationships between levels of ACE exposure and physical, mental, and behavioral health indicators including cigarette use, e-cigarette use, drinking and driving, obesity, lifetime depression, suicide ideation and attempt, non-suicidal self-injury, and lack of restful sleep. ACE-exposed females reported worse mental health status than ACE-exposed males while males reported more substance use than females. Most outcomes did not vary significantly by sex. CONCLUSION: The strong, graded relationships observed between ACE exposure and health status among young adults reinforce the need for trauma-informed intervention programs on college campuses.

The relationships between emerging adult transition themes, adverse childhood experiences, and substance use patterns among a community cohort of Hispanics.

BACKGROUND: Emerging adulthood (ages 18-26) is a time of identity exploration, experimentation, focusing on self or others, and instability, themes captured in the Inventory of Dimensions of Emerging Adulthood (IDEA). Preliminary evidence suggests that emerging adults (EAs) with a history of adverse childhood experiences (ACE) score differently on transition dimensions than their peers, however, the role of ACE in the IDEA-substance use relationship is unknown. METHOD: Data are from a longitudinal study of acculturation and health among Hispanics in California (N = 1,065). Multivariable regression models assessed the association between IDEA and ACE (no ACE, 1-3 ACE, and ≥ 4 ACE) for substance use behaviors over 2 time points. Interaction terms assessed whether ACE moderated the association between subjective perceptions of IDEA at age 20 and substance use at age 24. RESULTS: ACE-exposed EAs scored higher on identity exploration, instability, self-focus, and experimentation dimensions than their peers (ps < .01-.001). Scores on experimentation, identity exploration, and self-focus at age 20 were associated with divergent patterns of substance use across ACE exposure categories. In comparison to other groups, individuals in ≥ 4 ACE group who strongly identified with these transition themes at age 20 had the highest probability of binge drinking, past 30-day alcohol, marijuana, and illicit drug use at age 24 (adjusted odds ratios = 1.09-1.49, confidence interval [1.02-2.58]). CONCLUSION: Our findings suggest that ACE can affect subjective perceptions of transition themes and increased risk for substance use over time. Implications for substance use prevention efforts tailored to Hispanic EAs are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Role of Social Support in the Association between Childhood Adversity and Adolescent Self-injury and Suicide: Findings from a Statewide Sample of High School Students.

Extensive literature documents that adverse childhood experiences increase risk for non-suicidal self-injury (NSSI) and suicide behaviors among adolescents. However, few studies have examined patterns of co-occurring family based adversities, whether distinct patterns of adversity are differentially associated with NSSI and suicide behaviors, and if social support can offset the impact of adversity for these behaviors. This study used a statewide school-based sample that was 50.1% female, 71% non-Hispanic White, and evenly divided by grade (9th grade N = 39,682; 11th grade N = 33,966). Latent class analysis identified three mutually exclusive, homogeneous subgroups of co-occurring familial adversities; low or no family based adversity, parental dysfunction but low maltreatment, and parental dysfunction plus maltreatment. The relationships between membership in the identified subgroups and past year NSSI, suicidal ideation, and suicide attempt were assessed separately for 9th graders (average age = 14) and 11th graders (average age = 17). Although membership in the parent dysfunction plus maltreatment class was associated with the highest odds of NSSI, suicidal ideation, and suicide attempt, membership in either class of familial adversity elevated risk for these behaviors compared to membership in the low or no adversity class. Whether the protective effects of perceived peer and teacher social support moderated these associations and varied across age groups was also explored. The findings suggest that peer and teacher social support can promote positive outcomes even for youth living in stressful family conditions and that the protective effects of social support increase as the number of sources of support expands.

Substance Use Outcomes for Hispanic Emerging Adults Exposed to Incarceration of a Household Member during Childhood.

This study investigates whether Hispanic emerging adults exposed to household incarceration before age 18 report higher rates of past 30-day cigarette, alcohol, binge drinking, marijuana use, and negative substance use consequences, relative to participants not exposed to incarceration of a household member. Respondents were matched on key characteristics to create balanced groups of exposed and nonexposed respondents. Negative binomial regression models assessed primary research questions. There were significant long-term associations between household incarceration and the frequency of past 30-day binge drinking, marijuana use, and number of negative substance use consequences. Policies and health programs addressing household incarceration may be a promising prevention approach to reduce negative substance use outcomes among Hispanic emerging adults.

Adverse Childhood Experiences, Ethnicity, and Substance Use among College Students: Findings from a Two-State Sample.

Objectives: Despite college students reporting high rates of substance use and adverse childhood experiences (ACE), few studies have examined ACE-related substance use patterns with diverse student samples. We estimated the prevalence of ACE and substance use and investigated ethnic differences in the relationship between ACE and substance use among college students from two states. Design: Data are responses (N = 7,148) on the National College Health Assessment (in California) and the College Student Health Survey (in Minnesota). Multivariable regression models assessed the associations between individual and accumulated ACE and alcohol, tobacco, marijuana, and illicit substance use and binge drinking (adjusting for age, gender, depression, and state) among non-Hispanic White, Hispanic, African American/Black, Asian Pacific Islanders, multiracial, and other students. Interaction terms were calculated to test for ethnic differences. Results: In the month preceding the survey, 22% of students used marijuana, 28% used tobacco, 75% drank alcohol; 6% used an illicit drug in the past year and 30% acknowledged past 2-week binge drinking. Although ACE were associated with all substance use behaviors (AORs ranged from 1.19 to 1.54, p < .001), there was significant ethnic variation in ACE exposure (40-52%) and the dose-response relationship between ACE and marijuana and tobacco use and binge drinking. Conclusions: The variability in ACE-related substance use patterns across ethnic groups highlights the need for research that advances our understanding of sociocultural influences in trauma response and the role that campus communities could have in the development of culturally sensitive services that address this issue.

The Role of Familial Incarceration and Ethnic Identity in Suicidal Ideation and Suicide Attempt: Findings from a Longitudinal Study of Latinx Young Adults in California.

Suicide is a leading cause of death among young adults; however, contextual risks and cultural factors are rarely studied in the context of ethnic minority suicidal ideation (SI) and suicidal attempt (SA). This study assessed the association between familial incarceration and suicide behaviors and examined ethnic identity as a potential moderator. Data from a longitudinal study of health among Hispanics (n = 1,094) in California were used to test associations between familial incarceration, ethnic identity, and SA and SI, adjusting for demographic factors and covariates. Approximately 18% and 8% of respondents reported SI and SA, respectively. Compared to no incarceration, or the incarceration of a relative, parental incarceration was associated with higher odds (AOR: 2.09, 95% CI: 1.23-3.34) of SI whereas higher affective ethnic identity reduced the odds (AOR: 0.52, 95% CI: 0.31-0.89) of SA. Ethnic identity moderated the association between parental incarceration and SI (AOR: 0.33, 95% CI: 0.13-0.79). Incarceration of a family member can set the stage for exclusion from critical institutions and can have long-term consequences for adult mental health. Promoting a positive ethnic identity may be a promising prevention strategy that could bolster resilience among at-risk, urban minority youth.

School Practices to Foster LGBT-Supportive Climate: Associations with Adolescent Bullying Involvement.

Lesbian, gay, bisexual, and transgender (LGBT) youth experience disproportionate rates of bullying compared to their heterosexual peers. Schools are well-positioned to address these disparities by creating supportive school climates for LGBT youth, but more research is needed to examine the variety of practices and professional development opportunities put in place to this end. The current study examines how school practices to create supportive LGBT student climate relate to student reports of bullying. Student-level data come from the 2013 Minnesota Student Survey, a state-wide survey of risk and protective factors. Ninth and eleventh grade students (N = 31,183) reported on frequency of physical and relational bullying victimization and perpetration and sexual orientation-based harassment. School administrators reported on six practices related to creating supportive LGBT school climate (N = 103 schools): having a point person for LGBT student issues, displaying sexual orientation-specific content, having a gay-straight alliance, discussing bullying based on sexual orientation, and providing professional development around LGBT inclusion and LGBT student issues. An index was created to indicate how many practices each school used (M = 2.45; SD = 1.76). Multilevel logistic regressions indicated that students attending schools with more supportive LGBT climates reported lower odds of relational bullying victimization, physical bullying perpetration, and sexual orientation-based harassment compared to students in schools with less supportive LGBT climates. Sexual orientation did not moderate these relations, indicating that LGBT-supportive practices may be protective for all students, regardless of their sexual orientation. Findings support school-wide efforts to create supportive climates for LGBQ youth as part of a larger bullying prevention strategy.

Longitudinal, reciprocal relationships between family management and antisocial peer associations.

INTRODUCTION: Poor family management and antisocial peer associations are related risk factors for negative outcomes such as adolescent substance misuse and conduct disorders. The relationship between family management and antisocial peer associations is complex. The purpose of this study was to test the reciprocal relationships between youth-reports of poor family management and antisocial peer associations over multiple time-points. METHODS: We used four data points (5th-11th grade) from the Australian arm of the longitudinal International Youth Development Study (IYDS) to test a random-intercepts cross-lagged path model (N = 922). RESULTS: The model fit the data well with path estimates showing that poor family management predicted greater antisocial peer associations at the next wave but not the reverse. A second model included a third autoregressive path to control for youth's own antisocial behavior; the direction of the relationships between poor family management and antisocial peer associations did not change. CONCLUSIONS: These results indicate that across adolescence poor family management predicts greater antisocial peer association, which provides evidence that family-focused interventions are an important prevention strategy even in adolescence.

Adverse Childhood Experiences and Early Initiation of Marijuana and Alcohol Use: The Potential Moderating Effects of Internal Assets.

INTRODUCTION: Early adolescence is a critical risk period for initiation of substance use. Internal assets (IAs), which are individual qualities guiding positive choices, and adverse childhood experiences (ACEs) are important protective and risk factors, respectively, against substance use. The purpose of this study is to investigate whether IAs modify associations between ACEs and early initiation of alcohol and marijuana use. METHOD: Data were from 9th and 11th graders who completed the 2013 Minnesota Student Survey (n = 79,339). Students reported on experiences of abuse, household dysfunction, and substance use. Multivariable logistic regressions examined associations between different types of ACEs and substance use. Interactions between IAs and ACEs were added to models to test effect modification. For significant interactions, main effects models were re-estimated at different percentiles of IAs. RESULT: IAs moderated associations of both abuse and household dysfunction with early initiation of marijuana (p <.003) and alcohol (p =.007) for females but not for males. For females with low IAs, odds of early initiation of marijuana were approximately twice as high as students without any ACEs. A similar pattern was detected for females' initiation of alcohol use. No effect modification was detected for IAs and experiencing only abuse or household dysfunction on initiation. CONCLUSION: Special attention should be paid to improving IAs among girls who have already experienced ACEs. Future research should examine protective factors that buffer the effects of ACEs for boys.

Perceived discrimination, cultural identity development, and intimate partner violence among a sample of Hispanic young adults.

OBJECTIVE: Despite the prevalence of interpersonal violence (IPV), scientific understanding of the risk and protective factors for unidirectional and bidirectional IPV, and especially the role of sociocultural variables in these behaviors, is limited. This study investigates the association between ethnic-identity search, ethnic-identity affirmation, perceived discrimination, and unidirectional (victimization only, perpetration only) and bidirectional (reciprocal violence) IPV behaviors among foreign-born and U.S.-born Hispanic young adults. METHOD: Data are from Project RED (Reteniendo y Entendiendo Diversidad para Salud), a study investigating the effect of psychosocial and sociocultural factors on health behavior among a community sample of Hispanic young adults in Southern California (n = 1,267). RESULTS: Approximately 40% of the sample reported unidirectional or bidirectional IPV, with significant gender differences across the three categories. Compared with men, women had approximately 70% lower odds of victimization (OR = 0.31, 95% CI = 0.15-0.71), over twice the odds of perpetration (OR = 2.53, 95% CI = 1.98-3.62), and 35% higher odds (OR = 1.35, 95% CI = 1.04-1.81) of bidirectional IPV. Higher ethnic-identity affirmation was protective for victimization (OR = 0.86, 95% CI = 0.81-0.99) and bidirectional IPV (OR = 0.72, 95% CI = 0.62-0.89), whereas higher perceived discrimination scores increased the odds for bidirectional IPV (OR = 1.37 95% CI = 1.26-1.56) and was particularly detrimental for foreign-born participants. CONCLUSION: Intervention strategies should consider gender-specific risk profiles, cultural contexts, and the influence of sociocultural stressors. Addressing the harmful effects of perceived discrimination and leveraging the protective effects of ethnic-identity affirmation may be promising IPV-prevention strategies for Hispanic young adults. Future research directions and implications are discussed. (PsycINFO Database Record

Changes in the strength of peer influence and cultural factors on substance use initiation between late adolescence and emerging adulthood in a Hispanic sample.

We examine whether peer substance use and cultural factors differentially influence the initiation of tobacco, alcohol, and marijuana use in adolescence and emerging adulthood (EA) among a community-based sample of Hispanics. Participants provided data in 11th grade (M = 16.8 years old, SD = 0.54) and emerging adulthood (M = 20.3 years old, SD = 0.6). Peer tobacco use had a stronger association with initiation of tobacco use in emerging adulthood (OR = 1.46, 95% CI = 1.13, 1.89) than in adolescence (OR = 1.20, 95% CI = 1.03, 1.40), but this pattern was not observed with initiation of alcohol or marijuana use. Cultural orientation is associated with initiation of tobacco use during EA but not with initiation of alcohol or marijuana use.

Evaluation of a telenovela designed to improve knowledge and behavioral intentions among Hispanic patients with end-stage renal disease in Southern California.

OBJECTIVES: Culturally relevant education is needed to improve rates of successful kidney transplantation among Hispanic patients with end-stage renal disease (ESRD). This study examined whether patients' knowledge about kidney disease, postoperative care, and proactive health practices improved after watching a telenovela series about ESRD. DESIGN: 334 ESRD patients and 94 family members/caregivers were assigned to watch a telenovela ('Fixing Paco,' a bilingual health education film) or receive standard of care at a transplant center or at a dialysis clinic. Outcomes for pre-transplant patients assigned to standard of care at dialysis centers or at a transplant center were compared to pre-transplant patients in the treatment condition (standard of care + telenovela). RESULTS: Knowledge and behavioral intention scores at baseline across conditions and locations were similar, suggesting that assignment resulted in comparable groups at baseline. Using linear regression, this study found statistically significant improvements in knowledge scores among the telenovela group as compared to the standard of care groups. The telenovela group also had greater improvements in behavioral intention scores compared to the standard of care groups. Family members assigned to the telenovela group had significant improvements in knowledge scores as compared to the standard of care groups. CONCLUSION: Being well informed about ESRD and adopting proactive health behaviors are important mechanisms in improving transplantation outcomes. These findings suggest that knowledge about kidney disease, postoperative care, and proactive health practices could be improved by viewing a telenovela. Implications, limitations, and directions for future research are discussed.

Predictors of alcohol-related negative consequences in adolescents: A systematic review of the literature and implications for future research.

OBJECTIVE: To conduct a systematic review of the literature examining risk and protective factors of alcohol related negative consequences (ARNCs) among adolescents. METHODS: We conducted a systematic search of original empirical articles published between January 1, 1990 and June 1, 2015. The qualitative synthesis was performed using the Theory of Triadic Influence as a framework. RESULTS: Fifty-two studies were reviewed. Intrapersonal (e.g., personality traits, drinking motives and expectancies, depression), interpersonal (e.g., parental and peer alcohol use, violence exposure) and attitudinal factors (e.g., media exposure to alcohol, religiosity) influence ARNCs. Emerging evidence of new trends contributing to ARNCs include ready mixed alcohol drinks and childhood trauma and abuse. CONCLUSIONS: Risk factors from all domains of influence were observed. More research is needed on protective factors and how alcohol use interacts with preventive factors in predicting ARNCs. The conceptualization of negative consequences varies significantly between studies and may impact the external validity of previous research.